TY - JOUR
T1 - Combined association of lipids and blood pressure in relation to incident cardiovascular disease in the elderly
T2 - The cardiovascular health study
AU - Wong, Nathan D.
AU - Lopez, Victor A.
AU - Roberts, Craig S.
AU - Solomon, Henry A.
AU - Burke, Gregory L.
AU - Kuller, Lewis
AU - Tracy, Russell
AU - Yanez, David
AU - Psaty, Bruce M.
N1 - Funding Information:
Acknowledgments: The research reported in this article was supported by contracts N01-HC-85079 through N01-HC-85086, N01-HC-35129, N01 HC-15103, N01 HC-55222, and U01 HL080295 from the National Heart, Lung, and Blood Institute, with additional contribution from the National Institute of Neurological Disorders and Stroke. A full list of participating CHS investigators and institutions can be found at http://www.chs-nhlbi.org.
PY - 2010/2
Y1 - 2010/2
N2 - Background Hypertension and dyslipidemia are highly prevalent in the elderly. We studied the combined impact of both conditions on cardiovascular disease (CVD) events.MethodsWe studied 4,311 participants aged 65-98 (61.2% female) from the Cardiovascular Health Study (CHS), a longitudinal epidemiologic study, with no prior CVD. We evaluated the relation of low-density lipoprotein (LDL), high-density lipoprotein (HDL), or non-HDL-cholesterol combined with blood pressure (BP) categories to incident CVDincluding coronary heart disease (CHD) (angina, myocardial infarction (MI), angioplasty, coronary bypass surgery, or CHD death), stroke, claudication, and CVD death over 15 years.ResultsCVD incidence (per 1,000 person years) ranged from 38.4 when BP <120/80mmHg and LDL-C <100mg/dl to 94.8 when BP ≥160/100mmHg and LDL-C ≥160mg/dl, and from 28.9 when BP <120/80mmHg and HDL >60mg/dl to 87.1 for a BP ≥160/100 and HDL-C <40mg/dl. Compared with those with BP <120/80mmHg with either LDL-C <100mg/dl or HDL-C ≥60mg/dl, hazard ratios (HRs) for CVD events were 2.1 when BP ≥160/100mmHg and LDL-C ≥160mg/dl and 2.1 when BP ≥160/100 and HDL-C <40mg/dl (all P< 0.01), with similar results for non-HDL-C. Elevated BP was associated with increased risk across all lipid levels. Increased LDL-C added risk mainly when BP <140/90mmHg, but lower HDL-C also predicted CVD in those with higher BP.ConclusionIncreased BP confers increased risks for CVD in elderly persons across all lipid levels. Although increased LDL-C added risk mainly when BP 140/90mmHg, low HDL-C added risk also in those with hypertension. These results document the importance of combined hypertension and dyslipidemia.
AB - Background Hypertension and dyslipidemia are highly prevalent in the elderly. We studied the combined impact of both conditions on cardiovascular disease (CVD) events.MethodsWe studied 4,311 participants aged 65-98 (61.2% female) from the Cardiovascular Health Study (CHS), a longitudinal epidemiologic study, with no prior CVD. We evaluated the relation of low-density lipoprotein (LDL), high-density lipoprotein (HDL), or non-HDL-cholesterol combined with blood pressure (BP) categories to incident CVDincluding coronary heart disease (CHD) (angina, myocardial infarction (MI), angioplasty, coronary bypass surgery, or CHD death), stroke, claudication, and CVD death over 15 years.ResultsCVD incidence (per 1,000 person years) ranged from 38.4 when BP <120/80mmHg and LDL-C <100mg/dl to 94.8 when BP ≥160/100mmHg and LDL-C ≥160mg/dl, and from 28.9 when BP <120/80mmHg and HDL >60mg/dl to 87.1 for a BP ≥160/100 and HDL-C <40mg/dl. Compared with those with BP <120/80mmHg with either LDL-C <100mg/dl or HDL-C ≥60mg/dl, hazard ratios (HRs) for CVD events were 2.1 when BP ≥160/100mmHg and LDL-C ≥160mg/dl and 2.1 when BP ≥160/100 and HDL-C <40mg/dl (all P< 0.01), with similar results for non-HDL-C. Elevated BP was associated with increased risk across all lipid levels. Increased LDL-C added risk mainly when BP <140/90mmHg, but lower HDL-C also predicted CVD in those with higher BP.ConclusionIncreased BP confers increased risks for CVD in elderly persons across all lipid levels. Although increased LDL-C added risk mainly when BP 140/90mmHg, low HDL-C added risk also in those with hypertension. These results document the importance of combined hypertension and dyslipidemia.
KW - Blood pressure
KW - Cardiovascular disease
KW - Dyslipidemia
KW - Hypertension
KW - Risk factors
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U2 - 10.1038/ajh.2009.216
DO - 10.1038/ajh.2009.216
M3 - Article
C2 - 19927131
AN - SCOPUS:75649090487
SN - 0895-7061
VL - 23
SP - 161
EP - 167
JO - American Journal of Hypertension
JF - American Journal of Hypertension
IS - 2
ER -